Posterior Nasal Neurectomy for Allergic and Non-Allergic Rhinitis: Efficacy, Safety, and Predictive Factors

Area of Science:

• Otolaryngology
• Rhinology
• Surgical Innovation

Background:

• Chronic rhinitis, both allergic and non-allergic, poses significant challenges for patients refractory to conservative management.
• Posterior nasal neurectomy (PNN) offers a less invasive alternative to traditional Vidian neurectomy for managing severe nasal hypersecretory conditions.

Purpose of the Study:

• To evaluate the efficacy and safety of Posterior Nasal Neurectomy (PNN) in patients with chronic rhinitis.
• To assess the impact of PNN on nasal discharge severity and patient-reported outcomes.

Main Methods:

• A retrospective study of 37 patients undergoing PNN between 2020-2024.
• Nasal discharge severity was quantified using the Visual Analogue Scale (VAS) pre- and post-operatively (minimum 3 months follow-up).
• Surgical success was defined as a ≥50% reduction in VAS score.

Main Results:

• 81.1% of patients (30/37) achieved surgical success, with a significant VAS reduction from 8.5 to 2.1.
• Younger patients and those with atopy demonstrated better VAS improvement.
• No major complications were reported; transient nasal itching occurred in 5.4% of patients.

Conclusions:

• Posterior Nasal Neurectomy (PNN) is a safe and effective surgical option for intractable chronic rhinitis.
• PNN is particularly beneficial for young, atopic individuals with allergic rhinitis unresponsive to medical therapy.
• It serves as a viable alternative for patients unsuitable for or unwilling to undergo allergen immunotherapy.